Partial central anterior reconstruction of the auricle with one-stage combined retroauricular flaps.

Basal cell carcinomas of the central anterior area of the auricle, limited to the antihelix and scapha without peripheral infiltration of the helix, are not uncommon. Surgical resection is rarely transfixing but the resection of the underlying cartilage is often required. The complex anatomy of the ear, and the lack of local tissue available makes its reparation challenging. Defects of anthelix and scapha require special reconstructive techniques, taking into account skin structure and the three-dimensional architecture of the ear. Usually, the reconstruction consists of full-thickness skin grafting, or anterior transposition flap requiring an extended skin resection. We describe a one-stage technique that uses a pedicled retroauricular skin flap turned over the anterior defect, followed by immediate closure of the donor site with a transposition or a bilobed retroauricular skin flap. The one-stage combined retroauricular flaps reparation optimizes cosmetic outcome, reduces risks of successive surgeries.

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